Provider Demographics
NPI:1730979667
Name:MINDMD LLC
Entity type:Organization
Organization Name:MINDMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-432-1088
Mailing Address - Street 1:783 BEDFORD AVE
Mailing Address - Street 2:2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-1567
Mailing Address - Country:US
Mailing Address - Phone:914-432-1088
Mailing Address - Fax:914-432-1112
Practice Address - Street 1:783 BEDFORD AVE
Practice Address - Street 2:2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1567
Practice Address - Country:US
Practice Address - Phone:914-432-1088
Practice Address - Fax:914-432-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty